PT  - JOURNAL ARTICLE
AU  - Yash Paul Sharma
AU  - Krishna Prasad
AU  - Nitin Patel
AU  - Prashant Kumar Panda
TI  - Acute myocardial infarction in a young patient with triple valve replacement
AID  - 10.1136/bcr-2020-240732
DP  - 2021 Jul 01
TA  - BMJ Case Reports
PG  - e240732
VI  - 14
IP  - 7
4099  - http://casereports.bmj.com/content/14/7/e240732.short
4100  - http://casereports.bmj.com/content/14/7/e240732.full
SO  - BMJ Case Reports2021 Jul 01; 14
AB  - Rheumatic heart disease is an important cause of mortality and morbidity in developing countries, and is the leading cause of triple valve replacement. Myocardial infarction (MI) in such cases can be due to the coronary embolism from the prosthetic valves or due to atherosclerotic vascular disease. Intravascular imaging helps in delineating the cause. We present a case of a 34-year-old premenopausal woman with no conventional cardiovascular risk factors and had triple valve replacement 4 years ago and anterior wall MI with cardiogenic shock and left ventricular failure. She was managed with mechanical ventilation, thrombolysis, diuretics, double antiplatelets and anticoagulation with low molecular weight heparin. Intravascular ultrasound showed a lipid-rich plaque with associated plaque rupture and thrombosis. Intravascular imaging helps in delineating the cause of MI and further management. Atherosclerotic MI in a patient with no conventional risk factors is rare and needs to be considered.